Levetiracetam in Patients With Impulsive Aggression: A Double-Blind, Placebo-Controlled Trial
J Clin Psychiatry 2008;69(2):310-315
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: There are few controlled studies evaluating drug
treatment for impulsive aggression. The objective of this study was to evaluate
levetiracetam in patients with impulsive aggression, and whether diagnosis or
other baseline characteristics predict response.
Method: Outpatients with clinically significant impulsive
aggression (meeting Coccaro et al. revised criteria for intermittent explosive
disorder), without other psychiatric symptomatology clearly requiring
treatment, were randomly assigned to levetiracetam or placebo, double-blind,
for 10 weeks, at a variable dose with a maximum dose of 3000 mg/day. The
primary efficacy measure was change in the total aggression score from the
revised Overt Aggression Scale-Modified. The study was conducted from September
2005 to July 2006.
Results: Of 40 patients (20 in each treatment group), 34
completed at least 4 weeks of treatment with double-blind medication. There was
no overall statistical evidence of levetiracetam benefit, and no subgroup more
responsive to levetiracetam could be identified.
Conclusions: Levetiracetam was not as efficacious as
oxcarbazepine was in a prior similar study. Additional studies of medications
for impulsive aggression seem warranted.